PB2435: ALLOGENEIC STEM CELL TRANSPLANTATION OUTCOMES IN HODGKIN LYMPHOMA: A PROGNOSTIC STUDY OF 30 PATIENTS WITH RELAPSED AND REFRACTORY HODGKIN LYMPHOMA
Authors: Shayan Zamani, Mahshid Mehdizadeh, Amineh Salem
Journal: HemaSphere (2023)

Topic: 22. Stem cell transplantation - Clinical Background: Hodgkin Lymphoma (HL) is a type of hematologic malignancy. With the progress made in the field of regenerative medicine and cell-based therapies, hematopoietic stem cell transplantation (HSCT) has sparked new hopes and ideas for treatment of hematologic cancers. Currently, autologous HSCT (auto-HSCT) is the first-choice method of transplant for HL patients. Nevertheless, based on the previous studies, response rates highly depend on proper case selection and not all HL subjects benefit from auto-HSCT, such as the case for refractory HL patients. Allogeneic HSCT (allo-HSCT) on the other hand is hypothetically an alternative option for refractory HL patients, yet, there is little data on the efficacy of this method in HL and the results remain controversial. Aims: This retrospective prognostic study aimed, first, to determine the outcome of allogeneic- HSCT for HL patients; and second, to compare the 5 years overall survival (OS) between two groups of relapsed and refractory HL. Methods: 30 patients with relapsed and refractory HL were selected; these included those who had relapsed after autograft-HSCT (20/30) or who did not achieve minimum partial remission after salvage chemotherapy in the first place and were not candidate for auto-HSCT (10/30). All the included patients underwent allogeneic HSCT at Taleghani BMT center, Tehran, Iran from 2007 to 2019. Patients’ transplant record was followed for a mean of 60 months post-transplant. Also, data on gender, HL pathologic subtype, history of radiotherapy, history of bulky disease and graft-versus-host disease (GVHD), and were extracted. The overall survival (OS) was reported for all patients, patients with autologous-HSCT failure and a consequent allo-HSCT (group I) and patients without auto-HSCT who underwent allo-HSCT (group II). Results: Mean 5 years OS was determined 29.7, 42.1 and 17.3 months for all patients, group I and group II, respectively. Regardless of radiotherapy and bulky disease, there were statistically meaningful trends in OS related with gender, HL subtype and GVHD. The findings among all patients were, Complete remission (CR): 45%, Partial remission: 10%, relapse but alive: %5, Relapse and dead: 25%, Non relapse mortality (NRM): 15%. The findings in group I were: CR:60%, PR:20%, relapse but alive: 10%, relapse and dead:10%. Finally, the findings in group II were, CR: 30%, Relapse and dead: 40%, NRM: 30%. Although, CR was 45 % for all patients, the CR for group I was obtained 60 % whilst in group II, the CR was reduced to 30 %. Summary/Conclusion: Relapsed patients were found to have better transplant outcomes in comparison to refractory patients. Also, patients with GVHD had better OS in this study. Even though refractory patients generally have a poor prognosis, allo-HSCT still can come about to be an acceptable alternative option. Keywords: Stem Cell Transplantation, Outcomes, Hodgkin Lymphom. Figure legends: Figure 1. Percent of defining events after allogenic-HSCT for patients with autograft- HSCT failure (group I) and patients without prior autograft- HSCT (group II).Keywords: relapsed/refractory, Relapsed lymphoma, HSCT, Hodgkin’s lymphoma